Assisted Living Referral

Is a client in need of Assisted Living Services? Please provide as much detail as possible in the referral form below. Once submitted, our team will review it and respond promptly.

Client Information

First Name

Last Name

Date of Birth

PMI Number

Phone Number

On Medical Assistance (MA)?

On a Waiver? (CADI, EW, DD, BI)

Care Needs & Preferences

Describe Functional or Cognitive Support Needs

Is the client currently in a facility?

Current Facility Name (if any)

Desired Move-in Date

Furnished Unit Needed?

Case Manager Information

Full Name

County or Agency

Phone Number

Email Address

Will this Case Manager remain involved in ongoing care coordination?

Upload Supporting Documents

Upload CSSP / MnCHOICES / Service Plan

Upload POA or Guardianship Info (if applicable)

Comfort Living Services is a Minnesota-based provider offering a range of supportive services to help individuals achieve safe, stable, and healthy living. We serve people across the state who need reliable assistance with housing, daily care, and community connections. Our team works closely with each client to understand their needs and coordinate the right services, ensuring people facing disabilities, mental health challenges, chronic health conditions, or transitions from correctional or institutional settings get the support they need to achieve lasting stability.

Office Hours

Monday- Friday 8:00 am - 5:00 pm

952-444-9606